Marketing to Professionals: Key Opinion Control

Marketing effectively to physicians in today's pharmaceutical industry is more important than ever. No longer can companies rely solely on DTC and sales force efforts to increase drug and therapeutics revenue.

Jim Zuffoletti

Peer-to-peer programs have emerged as pharma's strategic means to narrow the knowledge gap between existing product data and physician awareness of this information. Key opinion leaders (KOLs) in the physician community are relied upon by their peers to provide a realistic assessment of a drug's effectiveness. Because of this, scientific discussions initiated by medical thought leaders stand out, especially in a highly regulated and media-saturated environment.

With pharma looking for efficient and effective ways to manage their relationships with leading physicians, KOL relationship management has now emerged as its own business discipline. Companies that create and maintain meaningful and complex relationships with KOLs on a mass scale will enjoy increased market share and revenues.

Otavio Freire

Because of federal and PhRMA guidelines, relationships with these physicians are heavily regulated. So it's not just managing the KOL relationships that pharma companies are struggling with, but also integrating this management across functional groups, from medical to marketing, and through the lifecycle of a drug, to derive an efficient, collaborative relationship. Pharma companies must make sure that coordination efforts don't create additional challenges or conflicts of interest.

KOLs are rapidly emerging as one of the most effective strategies for marketing drugs effectively. Companies typically spend 15 to 25 percent of their marketing budget on speaking events, many of which involve KOLs. Much of the promotional and educational material distributed by pharma also is built on research or studies executed by KOLs, further boosting their ROI for companies. A 2004 report by Cutting Edge highlighted KOL development as the second most important product-launch expenditure.

The Evolving KOL Relationship

Determining the best KOLs with whom to collaborate becomes a critical facet of the path that a particular drug or therapy will take. A KOL with a poor match in expertise, skills, or experience with company needs could negatively affect the support for a drug on the market, or even affect a drug's success or effectiveness before it hits the mass market.

In a recent Forrester Research survey in which a number of vice presidents, CIOs, and CMOs were interviewed regarding the impact of KOL relationships, participants identified KOL management practice as "extremely important" for management.

Pharma is willing to invest more in KOL management, but only with an empowered emphasis on efficiency. Six valuable interactions with a KOL can have more impact than eight inconsequential interactions—and it can be less expensive. KOLs themselves echo this thinking.

The public is not the only group losing patience with the pharmaceutical industry. KOLs are also losing faith in pharmaceutical companies. Some KOLs compare pharma companies to the many-headed Hydra of ancient mythology in terms of the different directions in which they move, and the positions they take. Moreover, KOLs feel the pain of an inefficient pharmaceutical company on their practices. An inefficient or wasteful interaction costs them time, which is their most precious commodity. Both parties concur that inefficiency is costly, agreeing that jointly attacking that inefficiency is a powerful means to collaboration.

The large number of potential KOLs makes enterprise-wide adoption of centralized KOL management an essential part of any brand program. While specifics vary by company size, type of therapy, and its adoption in the market, working with KOLs generally involves a number of critical elements, including:

A systematic approach to KOL identification and profiling The beginning of any KOL program starts with the answer to the question of "Who?" Who are the top thinkers in the field? Who are the next generation? And how can a company go about staying current with the answers to the above questions, while remaining consistent in their KOL identification methodology? Another key question to answer is "What?" All KOLs are not created equal and as pharma moves to engaging a KOL most efficiently, it is critical to understand the KOL's development objectives and capabilities.

A culture of transparent engagement and collaboration Easier said than done. It would be easy for pharma to shrink from engaging the leading thinkers in their specialties for fear of creating conflicts of interest. Many pharmaceutical companies have elected to put strict "no talk" guidelines in place between certain functional groups within a company and KOLs. While some restrictions should be called for, the degree to which a company is open with the KOL about their business objectives can limit the need for broad communication restrictions. If a pharma company is transparent in its intentions and collaborative in its manner, it is likely to avoid trouble and drive a better program.

A relationship-management process Like every other business process, new or old, a defined process supports monitoring, measurement, efficiency, and clarity, for all parties involved in a process. As KOL relationship management has emerged as a business consideration, the underlying process, with disciplines around actions such as planning, developing, identifying, and managing programs, needs to be considered and documented.

Adjustments to market-driven changes in a KOL relationship With turnover on brand teams happening as frequently as six months in some major pharmaceutical companies, it becomes very tempting to make this year's plans the same as last year's, even if the world has changed. Every KOL program has to be committed to making adjustments as the market changes—adjustments to KOL events, plans, and content. An adjustment might be a change in product positioning based on a suggestion by a KOL, or the alteration of scientific material after it has been presented by a KOL.

Without these KOL management practices in place, it is possible that several different departments within a company may unknowingly approach the same physician in different or even conflicting ways. Although a cross-section of various teams within pharma may be aware of their specific interactions with individual physicians, they are often unaware of the specific physician interactions within other departments of their organization. These actions could negatively affect the KOL relationship if one department overuses or overbooks that KOL, or if their expertise isn't being fully maximized.

A best practice of some of the principles mentioned above is observable in the medical device industry. At one major life science manufacturer, a KOL group had designed and implemented a program in which KOLs are systematically used over the course of the year according to a pre-established engagement plan specifying advisory meetings or training sessions. Uncoordinated actions, such as a regional event that conflicts with a planned national event, are discouraged. It is best to make time for interactions that are established up front (or ones that come up via a sensible revision process). But how is the plan created? It starts with a discussion about shared or independent objectives of the group and the KOL, and ends with a mutually agreed upon, completely transparent plan.

Measuring Impact

In an effort to comply with the recent emphasis on cost management, pharmaceutical companies have begun adopting strategic KOL management solutions that allow for goal-oriented information capture and communication, which include both timely reporting of key metrics and alignment with necessary regulations.

Understanding each physician network, the influences, locations, and the way information is disseminated, is essential to maximizing the effectiveness of KOL program dollars. And successful KOL management solutions, with adjustments as the KOL relationships are developed and executed, reflect positively on marketing and business goals at any pharmaceutical company.

Jim Zuffoletti is president and founder of OpenQ. He can be reached at jimz@openq.com

Otavio Freire is executive vice president and co-founder of OpenQ. He can be reached at otaviof@openq.com